The Snakebite Assistant App: A tool to reach out to people in need
To mark International Snakebite Awareness Day and a year on from its launch, Priyanka Kadam, Wellcome Trust/RSTMH Small Grant awardee 2021, along with Thomas Junghanss and Mauro Bodio share why they decided to create an app to assist with the treatment of snake bites. They look at what the first year of the app has show them.
Snakebite stands as one of the most overlooked tropical diseases, claiming around 63,000 lives each year worldwide, with a significant toll of 58,000 deaths occurring in India alone. The launch of the WHO Strategy on Snakebite Prevention and Control in May 2019 marked a turning point, urging afflicted nations to take the lead in integrating mitigation strategies into their healthcare frameworks.
The response from most countries has been sluggish in terms of policy formulation and investment. Often, non-governmental organizations have shouldered the responsibility of implementing mitigation projects, revealing the need for governments to actively allocate resources and take charge in alleviating this affliction that primarily affects the most vulnerable populations.
Our aim: designing and disseminating an app delivering information where it is needed
With diverse professional backgrounds authors from India (Priyanka Kadam), Germany (Thomas Junghanss), and Switzerland (Mauro Bodio) united to develop ‘The Snakebite Assistant’ App, aimed at assisting frontline workers, paramedics, medical professionals, and the public in preventing and managing venomous snakebites.
Mauro Bodio and Thomas Junghanss, based at SwissTPH, Basle Switzerland (Thomas Junghanss and Mauro Bodio) and Heidelberg University Hospital, Germany (Thomas Junghanss) secured funding from International Emergency Care Foundation (IECF), Fondation Botnar and Rudolf Geigy Stiftung (RGS) and Snakebite Healing and Education Society (SHEINDIA), Priyanka Kadam helped drive the project in India to develop the app together with WowLabz; Bangalore, India, and JUNIDAS, Stuttgart, Germany. Experts across fields of expertise in biology, medicine, community health and antivenom production in India were invaluable for the India-specific development of the app content.
|Watch the video ‚The Snakebite Assistant’ - A Training Tool The Snakebite Assistant App (English Tutorial) - YouTube (directed by Seema Muralidhara, Beacon TV)|
‘The snakebite Assistant’ app serves three purposes:
- The management of snakebite envenoming by victims and first responders, during patient transport (paramedics) and at the key levels of health care – primary (health centres) and secondary health care (district hospitals). The design of the app follows the logic of emergency medicine, supplemented by the specifics of envenoming and its treatment (antivenoms). It is based on the WHO Basic Emergency Care approach, WHO SE Asia Guidelines for the Management of Snakebites, WHO Snakebite Information and Data Platform, WHO Antivenom Risk-Benefit Assessment Procedure and Indian National Guidelines.
- Prevention of snakebite - of great importance in community work. A large proportion of bites can be avoided with education about the biology of the snake and the circumstances of the bite, as well as by using simple preventive measures (e.g., mosquito nets, flashlights, boots).
- The training, self-study, and education of laypersons and professionals in the areas of venomous snake biology, first aid, and clinical management of snakebite envenoming. The app can be run on BlueStacks for use on notebooks and desktops and projecting in lecture theatres. Videos and games for school children and adults complement the programme.
The users of ‘The Snakebite Assistant’
The users select the state and the health care level where they work tailoring the app content to their geographical position (venomous snakes in their region) and needs.
In case of a bite, the app instructs first responders and paramedics on how to stabilize and transport patientsto the hospital. Clinicians are guided to initiate care at the first point of contact, such as Primary Health Centres (PHCs) or Community Health Centres (CHCs), before transferring severely envenomed patients to higher-tier hospitals with ICU capabilities
The Snakebite Treatment Protocol
After selecting the level (‘victims & first responders’, ‘paramedics’, ‘Primary’ and ‘Secondary Health Care Level’), the central track of the app leads the users – tailored to their level of care - step-by-step through the management of an envenomed patient. The app follows the well-established standards of Emergency Medicine and antivenom therapy.
‘The Snakebite Assistant’ obeys general and patient data privacy protection, quality assurance, and liability issues as applicable to India and in compliance with WHO and international standards. We made sure that data privacy is built into the structure of the app, e.g., only after reading the warning not to enter any information allowing identification of the patient, the user can continue entering a patient’s details. Additionally, the system only allows to enter a patient ID and not the patient’s name.
Education and Training
The ‘Education & Training’ section offers links to informative material sorted by user level and videos in 12 regional languages, educating the public on bite prevention and guiding first responders on immediate actions prior to hospitalization.
Games on ‘snakes and their venoms’, ‘How to prevent snakebites’ and ‘Dos and Don’ts after a snakebite’ helps children, and, also, adults to learn in a playful manner.
Dissemination of ‘The Snakebite Assistant
The first regional version of the app was launched on 19th September 2022 in India and is currently in the category of 10K+ (10,001 - 50,000) downloads in Play Store. The team released a concise 4-minute tutorial English and Hindi, elucidating the app's functionalities. These tutorials quickly gained traction on platforms like WhatsApp and LinkedIn. The aspiration is for medical students, healthcare providers, and the public to utilize the app, fostering awareness and understanding of this Neglected Tropical Disease (NTD).
While currently tailored for India, the prototype of ‘The Snakebite Assistant’ App holds potential for adaptation in other afflicted world regions. With AP Interfaces to the web-based expert platform www.vapaguide.info, regional apps can be updated in real time without re-programming the appsitself, a very important feature of medical apps.
Its utility hinges on widespread smartphone usage, with India boasting over 1.2 billion mobile phone users, including around 650 million smartphone users, as per data from Counterpoint, a prominent market research firm. This vast user base presents an opportunity for substantial outreach in the upcoming months.
The subsequent phase involves building awareness and attracting the attention of the smartphone users in India towards leveraging technology to their benefit and ensuring the prevention and management of snakebites. It aims to provide medical professionals with the knowledge of effectively handling snakebite cases at primary healthcare facilities, stabilizing patients before transferring critical
cases requiring Intensive Care Unit (ICU) assistance to higher-level hospitals. We are excited about forging fresh partnerships across various domains and government and non-government agencies that can utilize the App's services to alleviate the impact of snakebites and help bring down the mortality and disability numbers.